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Uses of Flagyl (Metronidazole)

Metronidazole is a commonly used antibacterial and anti-protozoal agent. In this article, we shall briefly review the clinical applications of metronidazole.

1. Bacterial infections - Metronidazole is effective against a number of different bacteria. It is the treatment of choice in patients suffering from bacterial vaginosis that is caused due to Gardnerella species of organisms. In addition, it is useful in treating conditions such as peritonitis, aspiration pneumonia, lung abscess, empyema, endocarditis, bone and joint disease and even brain abscesses. Often, metronidazole is offered to the patient in combination with other antibiotics. For example, peptic ulcer disease that is caused due to Helicobacter pylori requires three antibiotics, one of which is metronidazole.

One of the most common reasons why metronidazole is described in hospitals is to manage diarrhoea that occurs due to Clostridium difficile bacteria. Clostridium difficile often goes in the bowels of patients who have been on long course of antibiotics and in whom the 'good bacteria' have been destroyed. It causes a condition called pseudomembranous colitis. Patients with Clostridium difficile have rather troublesome and distressing diarrhoea that is associated with abdominal pain and a great degree of inflammation within the bowel.

2. Protozoal infections - Metronidazole is also useful in treating protozoal infections. Common protozoal infections include amoebiasis, Giardiasis and trichomoniasis. The first two are causes of intestinal infections while the last can cause it vaginitis (sexually transmitted disease).

While these are the two main uses of metronidazole, there include a number of other reasons why it may be prescribed to patients. Metronidazole is often given to patients who are due to undergo any form of bowel surgery as this can carry a risk of infection. In patients who suffer from Crohn's disease, metronidazole is often prescribed along with other medication such as ciprofloxacin.

The list below details other indications where the metronidazole may be prescribed.

  • Chest infections such as aspiration pneumonia. Here, pneumonia occurs due to aspiration of food material into the lungs.
  • Cardiac infection such as infective endocarditis where the heart valves are affected.
  • Bone infections such as osteomyelitis and joint infection.
  • Neurological infection such as meningitis.
  • Pelvic inflammatory disease
  • Soft tissue infections
  • Skin infections such as acne rosacea
  • Metronidazole may also be prescribed to patients before they undergo bowel surgery or any form of surgery (surgical prophylaxis).

While metronidazole in the above cases may be given through an intravenous route or oral route, there are some cases in which it can be prescribed in the form of a topical application. For example, in patients suffering from acne rosacea, topical forms of metronidazole (cream or gel) are described as a form of treatment.

Finally, metronidazole is also available in the form of suppositories. This is useful in treating bowel disease such as Crohn's disease and similar infections.

Metronidazole is an effective antibacterial and antiprotozoal agent. It is used for a variety of different clinical conditions and is also utilised as prophylaxis against the development of infections.

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